Provider Demographics
NPI:1780013896
Name:WILLIAMS, TAMEKA LANETT
Entity Type:Individual
Prefix:
First Name:TAMEKA
Middle Name:LANETT
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 VERDE BOSQUE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3872
Mailing Address - Country:US
Mailing Address - Phone:323-304-8614
Mailing Address - Fax:
Practice Address - Street 1:5914 BURNING SUNRISE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1290
Practice Address - Country:US
Practice Address - Phone:323-304-8614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide